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CDC - Orthopoxvirus Testing Challenges for Persons in Populations at Low Risk or Without Known Epidemiologic Link to Monkeypox — United States, 2022

Mary Wilson

Well-known member
September 9, 2022

DOI: http://dx.doi.org/10.15585/mmwr.mm7136e1

Faisal S. Minhaj, PharmD[SUP]1[/SUP][SUP],2[/SUP]; Julia K. Petras, MSPH[SUP]1[/SUP][SUP],2[/SUP]; Jennifer A. Brown, DVM[SUP]3[/SUP]; Anil T. Mangla, PhD[SUP]4[/SUP]; Kelly Russo, MD[SUP]5[/SUP]; Christina Willut[SUP]4[/SUP]; Michelle Lee, MPH[SUP]4[/SUP]; Jason Beverley, MS[SUP]4[/SUP]; Rachel Harold, MD[SUP]4[/SUP]; Lauren Milroy, MPH[SUP]3[/SUP]; Brian Pope[SUP]3[/SUP]; Emily Gould, MD[SUP]6[/SUP]; Cole Beeler, MD[SUP]6[/SUP]; Jack Schneider, MD[SUP]6[/SUP]; Heba H. Mostafa, MD, PhD[SUP]7[/SUP]; Shana Godfred-Cato, DO[SUP]1[/SUP]; Eleanor S. Click, MD[SUP]1[/SUP]; Brian F. Borah, MD[SUP]1[/SUP][SUP],2[/SUP]; Romeo R. Galang, MD[SUP]1[/SUP]; Shama Cash-Goldwasser, MD[SUP]1[/SUP][SUP],2[/SUP]; Joshua M. Wong, MD[SUP]1[/SUP]; David W. McCormick, MD[SUP]1[/SUP]; Patricia A. Yu, PharmD[SUP]1[/SUP]; Victoria Shelus, PhD[SUP]1[/SUP][SUP],2[/SUP]; Ann Carpenter, DVM[SUP]1[/SUP][SUP],2[/SUP]; Sabrina Schatzman, PhD[SUP]1[/SUP][SUP],8[/SUP]; David Lowe, PhD[SUP]1[/SUP]; Michael B. Townsend, PhD[SUP]1[/SUP]; Whitni Davidson, MPH[SUP]1[/SUP]; Nhien T. Wynn, MS[SUP]1[/SUP]; Panayampalli S. Satheshkumar, PhD[SUP]1[/SUP]; Siobhán M. O’Connor, MD[SUP]1[/SUP]; Kevin O’Laughlin, MD[SUP]1[/SUP]; Agam K. Rao, MD[SUP]1[/SUP]; Andrea M. McCollum, PhD[SUP]1[/SUP]; María E. Negrón, DVM, PhD[SUP]1[/SUP]; Christina L. Hutson, PhD[SUP]1[/SUP]; Johanna S. Salzer, DVM, PhD[SUP]1[/SUP]; CDC Monkeypox Emergency Response Team

Summary

What is already known about this topic?

Testing for Monkeypox virus, using Food and Drug Administration 510(k)–cleared non-variola Orthopoxvirus real-time polymerase chain reaction (PCR) test and laboratory developed real-time PCR tests, is critical for diagnosis of suspected cases.

What is added by this report?

Three persons with atypical rashes, uncharacteristic illnesses, and absence of risk factors or an epidemiologic link to a known monkeypox case received false-positive real-time PCR test results; late cycle threshold values were all ≥34.

What are the implications for public health practice?

When testing specimens from patients with atypical signs and symptoms or without epidemiologic links or risk factors or where these are unknown, laboratories should reextract and retest specimens with real-time PCR Ct values that are high (≥34) to avoid unnecessary medical treatment and expenditure of public health resources.

https://www.cdc.gov/mmwr/volumes/71/wr/mm7136e1.htm#suggestedcitation
 
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